Abstract
A69-year-old female patient and a70-year-old male patient were admitted to hospital with recurrent, severe hypoglycemic episodes and atypical manifestation of Whipple's triad. In the female, elevated levels of insulin, C‑peptide and pro-insulin together with pathological findings during afasting test proved the presence of an insulinoma, which could be detected by Ga-68-DOTATOC-PET-CT in the pancreas. There was avery rare co-existence of aneuroendocrine Merkel cell carcinoma. In the male, levels of insulin and C‑peptide were suppressed and adiagnosis of paraneoplastic hypoglycemia by IGF‑2 secretion was made with increased glucose disposal in skeletal muscle proven by 18F‑FDG-PET-CT.
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